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I'm hearing of more and more activities that will require proof of vaccination: eating out, going to a concert, flying internationally — and likely at some point domestically in the U.S. Do I really need to carry around that awkwardly sized paper proof-of-vaccine card?
That flimsy 4-by-3-inch piece of paper is currently the best proof we have of vaccination, says Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention — and that's problematic.
"At the moment, you should carry the original vaccination card," says Frieden, who is now the CEO of Resolve to Save Lives, a nonprofit that focuses on public health. "That's not a good thing because a) you could lose it and b) if you're immunocompromised, you're essentially telling people that because you got a third dose, so it's revealing health information." And then, he adds, there's the possibility that unvaccinated people will just get fake cards. (Indeed, NPR reported on sales of blank cards on Amazon.com, even though using one is a crime.)
Frieden and others are advocating for national guidelines for a more secure, accurate and flexible system to prove you're vaccinated.
"The frank truth is, mandates and vaccine passports have become a political third rail, and the administration is understandably reluctant to take action in this area," he says. "But the result is that mandates will be harder to enforce and less secure."
So if you don't want to tote your paper card everywhere, what are the options? Depending on where you live, you might be able to go digital — at least, if you stay close to home.
New York, for example, uses an app called Excelsior Pass.
But when Frieden pulled up his Excelsior Pass recently, he noticed it had just expired, six months after his second dose. To extend it, he had to download an upgrade to the app. Also, downloading information on the spot can pose security and privacy issues, just like a credit card, "where some Big Brother knows about the customer, the shopkeeper and the transaction," points out Ramesh Raskar, a Massachusetts Institute of Technology Media Lab associate professor — not to mention hassles. Many users complain the app gets stuck on a blank blue screen.
And there is no guarantee that other states will be able or willing to use the app from your home state. Most current credential systems can only be verified by the apps in the state by which they're issued. So unless you happen to be traveling to a state that uses the same one, it probably won't get you far.
"A lot has to happen for everything to go right," Raskar says.
This includes your phone not dying as you're waiting in line.
"Technical issues such as a dead or lost phone are always concerns," says Henry Wu, director of Emory TravelWell Center and an associate professor of infectious diseases at the Emory University School of Medicine. And that's not the only potential digital flaw. "Even if you are enrolled in one of the digital vaccine certificate or passport systems, I would still always carry the original card during travel since no [digital] vaccine passport system is universally recognized," he says.
Some states, such as Hawaii, have apps designated for visitors to show proof of vaccination more easily while they're in the state, but others have banned vaccination verification apps altogether, considering them government overreach. Alabama's governor, for example, signed legislation in May that bans the use of digital vaccine credentials. Here's a state-by-state rundown of digital options compiled by PC Magazine.
An easier, cheaper and more secure electronic option would be for states to send residents a QR code that links to their vaccine status, says Raskar, who is also the founder of PathCheck Foundation, which creates software for vaccine credentials and exposure notifications apps. Israel, India, Brazil and China all use QR-based systems. QR codes use encrypted signatures, or electronic fingerprints, so they can't be copied and used for other names (although if someone stole your driver's license as well, they could presumably use your QR code).
You can store a QR code where you wish: literally on a piece of paper, as a photo on your phone, even within a fancy app.
However, that QR code technology can so far only be used within the city, state or country issuing it. Now that the U.S. has said it will allow vaccinated people from other countries to fly in, that proof will likely have to be in hard copy format for the time being. Check with your airline before traveling: Some accept apps that store a copy of your vaccine card.
"I do see a complicated challenge ahead of us, with documents from around the world to verify, and no current national digital vaccine passport standard that could help facilitate the process before travelers depart," Emory's Wu says. "I'm not sure we have even decided which vaccines we will accept as of yet." (And that's been a point of controversy elsewhere: The European Union, which does recognize a digital vaccine passport, only accepts certain vaccines.)
There's another possibility for Americans traveling abroad. If you have an International Certificate for Vaccination and Prophylaxis (ICVP, or "yellow card," a World Health Organization travel document), Wu suggests asking your vaccination provider to add your COVID-19 shots. "When traveling overseas you might encounter officials who are not familiar with our documents, so being able to prove your status in multiple ways can be very helpful," he says.
The bottom line: Don't lose that card (though, if you do, rest assured that your state retains the official record). Getting a replacement might not be easy, depending on the state. Also, instead of laminating it, consider a plastic sleeve vaccine holder: That way, it'll be easier to update if you get another shot.
Sheila Mulrooney Eldred is a freelance health journalist in Minneapolis. She's written about COVID-19 for many publications, including Medscape, Kaiser Health News, The New York Times and The Washington Post. More at sheilaeldred.pressfolios.com. On Twitter: @milepostmedia.